Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bascom Pharmacy LLC

Organization Long Term Care Pharmacy · NPI 1205719978

Bascom Pharmacy LLC is a Long Term Care Pharmacy in San Jose, California. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

105 N Bascom Ave Ste 101
San Jose, CA 95128-1811
Phone: (408) 995-6020
Fax: (408) 995-5320
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Long Term Care Pharmacy (primary) Taxonomy 3336L0003X

Record details

NPI number1205719978
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Clive Fuller — Manager · (510) 691-3371
NPI enumeratedJuly 29, 2025
Last updated in NPPESJuly 29, 2025
Certification dateJuly 29, 2025
Mailing address105 N Bascom Ave Ste 101, San Jose, CA 95128-1811

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